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Chemical Peel

Considerations before having a chemical peel

It is very important to find a doctor who has adequate training and experience in skin resurfacing.

In some states, a medical degree is not required to perform a chemical peel--even the strongest phenol peels--and many states have laws that permit nondoctors to administer certain peel solutions, but regulate the strengths that they are permitted to apply.

What is a chemical peel?

Chemical peeling uses a chemical solution to improve the skin's appearance. It can reduce or eliminate fine lines under the eyes and around the mouth, correct uneven skin pigmentation, remove precancerous skin growths, and soften acne or treat scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs.

Possible complications associated with chemical peels

Possible complications associated with chemical peels may include but are not limited to the following:

  • Change in skin tone color. For certain skin types, there is a risk of developing a temporary or permanent skin color change. Taking birth control pills, being pregnant, or having a family history of brownish discoloration on the face may increase the possibility of developing the abnormal pigmentation.
  • Scarring. Chemical peels can cause scarring. However, if scarring occurs, it can usually be treated effectively.
  • Infection. Exposing skin to bacteria sources before it is done healing, such as using makeup too early, can risk infection.
  • Cold sores and fever blisters. Those who are susceptible to cold sores, or herpes simplex infections, may have a reactivation of cold sores or fever blisters following a chemical peel.

Most complications after a chemical peel occur when posttreatment instructions are not followed correctly. Be careful to follow all instructions given to you by your doctor. A chemical peel is most commonly performed for cosmetic reasons to enhance appearance and self-confidence and may be performed in conjunction with a facelift or other cosmetic procedures. However, a chemical peel is not a substitute for a facelift and does not prevent or slow the aging process.

What substances are used for chemical peels?

Phenol, trichloroacetic acid, and alphahydroxy acids are used for chemical peels. The precise formula used may be adjusted for each patient:

  • Alphahydroxy acids (AHAs). AHAs, such as glycolic, salicylic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels that can often provide smoother, brighter-looking skin. AHA peels may be used to accomplish the following:
    • Reduce fine wrinkling
    • Treat areas of dryness
    • Reduce uneven pigmentation
    • Aid in control of acne
    • Smooth rough, dry skin
    • Improve texture of sun-damaged skin

    AHA peels may cause the following:
    • Stinging
    • Redness
    • Irritation
    • Crusting, flaking, or scaling
    • Dryness

    Generally, no anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.

    Protecting skin from the sun is important following AHA peels.

  • Trichloracetic acid (TCA). TCA can be used in many concentrations and is used to accomplish the following:
    • Smooth fine surface wrinkles
    • Remove superficial blemishes
    • Correct pigment problems

    TCA can be used on the neck or other body areas, and may require pretreatment with Retin-A or AHA creams. This procedure is preferable for darker-skinned patients.

    Anesthesia is not usually required for TCA peels because the chemical solution acts as an anesthetic. Although, sedation may be used before and during the procedure to help the patient relax. Two or more TCA peels may be needed over several months to obtain the desired result, although mild TCA peels may be repeated more frequently.

    The results of a TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. More than one TCA peel may be needed to achieve the desired result.

    TCA-peel patients are advised to avoid sun exposure for several months. The procedure also may produce some unintended color changes in the skin.

  • Phenol. Phenol is the strongest of the chemical solutions and produces a deep peel. A phenol peel is mainly used to accomplish the following:
    • Correct blotches caused by sun exposure, birth control pills, or aging
    • Smooth out coarse wrinkles
    • Remove precancerous growths

    • Should be used on the face only, as scarring may result if used on the neck or other body areas.
    • Is not recommended for darker-skinned individuals.
    • May pose risk for patients with heart problems.
    • May permanently remove facial freckles.
    • May cause permanent skin lightening.
    • May leave lines of demarcation.

    Recovery may be slow and complete healing may take several months.

    After a phenol peel, new skin may lose its ability to produce pigment. The skin will be lighter and will always have to be protected from the sun.

About the procedure

The procedure involves a chemical solution that is applied to the skin. The solution causes a layer of skin to separate and peel off over the course of a day up to two weeks, depending on the type and strength of the peel. The new, regenerated skin underneath is usually smoother, less wrinkled, and more even in color than the old skin.

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